Organization Active NPI

Maria T Isava, LCSW PLLC

  • Clinical Social Worker
  • Carrollton, TX
National Provider Identifier
1902447683
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MARIA T ISAVA, LCSW PLLC
Doing business as
Maria T Isava, LCSW
Maria T Isava, LCSW PLLC
Practice address
4425 Plano Pkwy Ste 701
Carrollton, TX 75010-5031
Phone
(469) 469-9557
NPI assigned
Oct 3, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Adele Marie Konyk
Title
Office Manger
Phone
(561) 702-8265

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

4425 Plano Pkwy Ste 701
Carrollton, TX 75010-5031

Mailing address

601 Shasta CT
Highland Village, TX 75077-7056
Phone (469) 469-9557

Other identifiers 2

IdentifierTypeStateIssuer
445232491OtherTXBCBS TEXAS
67389OtherTXLICENSURE

Other names 2

  • Maria T Isava, LCSW Doing business as
  • Maria T Isava, LCSW PLLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210205000338 TX Part B Supplier - Clinic/Group Practice 5193139996 Receives reassigned benefits from 1 practitioner
Practice locations: Highland Village, TX

National Provider Directory

National Provider Directory

Locations

4425 Plano Pkwy
Ste 701
Carrollton, TX 75010
Phone (214) 912-6720

1990 Justin Rd
Highland Village, TX 75077
Phone (469) 469-9557

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1902447683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 SHASTA CT",
            "city": "HIGHLAND VILLAGE",
            "state": "TX",
            "postal_code": "750777056",
            "telephone_number": "469-469-9557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 PLANO PKWY STE 701",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750105031",
            "telephone_number": "469-469-9557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIA T ISAVA, LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-03",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "KONYK",
        "authorized_official_first_name": "ADELE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANGER",
        "authorized_official_telephone_number": "561-702-8265"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TEXAS",
            "identifier": "445232491",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "67389",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maria T Isava, LCSW",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Maria T Isava, LCSW",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Maria T Isava, LCSW PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carrollton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.